The commentary of a board certified psychiatrist/sleep specialist/internist

Saturday, August 06, 2005

Medicare Benzodiazepine Exclusion

Psychiatric News reports on the Medicare Benzodiazepine exclusion:Last month APA praised Reps. Benjamin Cardin (D-Md.) and Jim Ramstad (R-Minn.) for co-sponsoring legislation that would reverse the exclusion of benzodiazepine medications from reimbursement under the new Medicare Part D drug benefit. The Medicare Modernization Act of 2003 (MMA) contained language that required that benzodiazepines be excluded from coverage by the new drug benefit, which begins January 1, 2006 (Psychiatric News, February 4). Psychiatrist Stevan Gressitt, M.D., founder of the Maine Benzodiazepine Study Group, told Psychiatric News during an interview for a previous article, "The alternatives really are grim. If these patients don't have access to benzodiazepines after January 2006, then they will most likely be switched to something that is covered—an SSRI or an atypical antipsychotic. Neither one of those would be my first choice for an elderly or disabled patient with multiple medical problems who is probably taking several other medications." Dr. Gressitt's comments don't make sense. For an elderly patient, an SSRI is often a better choice than a benzo. Most psychiatrists try to avoid benzodiazepines in the elderly due to the cognitive side effects and the risk of falls.

5 comments:

All benzo's are available as generic anyway- clonazepam $15/mo- valium $10/mo - even the elderly can afford these prices, though benzo's are generally avoided in the elderly. The FDA will probably soon black box them as they have the atypical antipsychotics.

Funny thing is is that both benzodiazepines and antidepressants are on the Beers list for senior citizens. They aren't supposed to be on these drugs anyways. It is not only my opinion, but also the opinion of others that any doctor who prescribes these meds to senior citizens is negligent.